Surgical device for complex suturing fibrous tissues

Abstract

Instruments for placing complex sutures into biological tissues, including instruments useful in arthroscopic surgical techniques which minimize incision size. The instruments manipulate tissue by, for example, rolling, wrinkling, folding, bending, or tucking the tissue so that a needle can be placed through the tissue more than once. Sutures are placed, for example from top-to-bottom and bottom-to-top with a single pass of a straight needle. In addition, the instruments can roll, wrinkle, fold, bend, or tuck the flat tissue so that a needle can be placed through the tissue more than once and a loop can be sutured through the tissue so that another suture can pass through resulting in sewing both sides of the tissue. This will allow surgeons to place complex locking and grasping suture configurations that will significantly improve the repair.

What is claimed is: 
     
         1 . A surgical instrument for placing complex sutures into tissues, the surgical instrument comprising:
 a first tip and a second tip;   a first tip position in which the first tip is spaced apart from the second tip;   the first tip operable to securely latch onto a tissue independent of the second tip and the second tip operable to securely latch onto the tissue independent of the first tip;   a second tip position, the second tip position including:
 at least one of the first tip and the second tip rotated to create a fold in the tissue; or 
 at least one of the first tip and second tip positioned closer to the other tip to create a fold in the tissue; and 
   a needle connected to a suture, wherein the needle and suture are operable to pass through the fold in the tissue in at least one direction.   
     
     
         2 . The surgical instrument of  claim 1 , wherein the surgical instrument is operable to perform rotator cuff surgery. 
     
     
         3 . The surgical instrument of  claim 1 , wherein the needle is a flexible needle. 
     
     
         4 . The surgical instrument of  claim 1 , wherein the needle is configured to pass through the folded tissue in a direction that is offset relative to at least one of the first tip and the second tip. 
     
     
         5 . The surgical instrument of  claim 1 , wherein at least one of the first tip and the second tip has a barb that is configured to at least partially penetrate the tissue and thereby securely latch onto the tissue. 
     
     
         6 . The surgical instrument of  claim 1 , wherein the first tip position includes the first tip and the second tip spaced apart in a first direction and the first tip and the second tip are configured to securely latch onto the tissue in a second direction that is non-parallel with the first direction. 
     
     
         7 . The surgical instrument of  claim 1 , wherein the tissue is a fibrous tissue. 
     
     
         8 . A surgical instrument for placing complex sutures into tissues, the surgical instrument comprising:
 a first tip and a second tip;   a first tip position in which the first tip is spaced apart from the second tip;   the first tip configured to at least partially penetrate a tissue independent of the second and the second tip configured to at least partially penetrate the tissue independent of the first tip;   a second tip position, the second tip position including:
 at least one of the first tip and the second tip rotated to create a fold in the tissue; or 
 at least one of the first tip and second tip positioned closer to the other tip to create a fold in the tissue; and 
   a needle connected to a suture, wherein the needle and suture are operable to pass through the fold in the tissue in at least one direction.   
     
     
         9 . The surgical instrument of  claim 8 , wherein the surgical instrument is operable to perform rotator cuff surgery. 
     
     
         10 . The surgical instrument of  claim 8 , wherein the needle is a flexible needle. 
     
     
         11 . The surgical instrument of  claim 8 , wherein the needle is offset to pass through a small amount of the folded tissue. 
     
     
         12 . The surgical instrument of  claim 8 , wherein the needle is offset to pass through a large amount of the folded tissue. 
     
     
         13 . The surgical instrument of  claim 8 , wherein the tissue is a fibrous tissue. 
     
     
         14 . The surgical instrument of  claim 8 , wherein at least one of the first tip and the second tip has a barb that is configured to penetrate the tissue. 
     
     
         15 . The surgical instrument of  claim 8 , wherein the first tip position includes the first tip and the second tip spaced apart in a first direction and the first tip and the second tip are configured to securely latch onto the tissue in a second direction that is non-parallel with the first direction. 
     
     
         16 . A method for inserting sutures into tissues, the method comprising:
 securely engaging tissue using a surgical instrument, wherein the surgical instrument includes at least a first tip configured to engage the tissue;   engaging the tissue at a first location;   manipulating the tissue to create a fold in the tissue without requiring a user to manually rotate the surgical instrument;   passing a needle with an attached suture through the first tip and through the fold in the tissue in a first direction, such that the needle passes through the tissue twice;   unfolding the tissue and relocating the first tip to a second location;   manipulating the tissue to create a subsequent fold in the tissue without requiring the user to manually rotate the surgical instrument; and   passing the needle with the attached suture through the subsequent fold in the tissue, such that the needle passes through the tissue twice.   
     
     
         17 . The method of  claim 16 , wherein the first tip is rotated an amount to rotate the engaged tissue at least 180 degrees. 
     
     
         18 . The method of  claim 16 , wherein creating the fold in the tissue includes rolling the tissue at least partially about the surgical instrument such that a portion of the tissue overlaps itself before the needle passes through the fold. 
     
     
         19 . The method of  claim 16 , wherein securely engaging the tissue includes penetrating the tissue with at least one barb disposed from the first tip to latch onto the tissue prior to creating the fold. 
     
     
         20 . The method of  claim 16 , further comprising engaging the tissue with a second tip of the surgical instrument, wherein the first tip and the second tip move relative to one another to create the fold in the tissue.